36779_RUSHER, JOHN_20031216

❑CAMA / ❑ DREDGE & FILL
r
4
GENERAL PERMIT
Previous permit#
i❑New ❑Modification ❑Complete Reissue ❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant
to 15A NCAC
_
Applicant Name r ��� /,, 1��'- , /
❑ Rules attached.
Project Location: County
i 11
Address_ A/ � ; s �.rl �iY .
Street Address/ State Road/ Lot #(s)
City State ,f%G- ZIP 27i G
Phone ## w ' r/ I-ZO Fax # ( )
Subdivision ; ;l/, •cam...
Authorized Agent
City /LA `'' �� /oc.. ZIP _
Affected ` Cw El • ❑ PTA 'XtS ❑ PTS
Phone # O River Basin
G OEA ElHHF ElIH ❑ UBA El N/A
AEC(s):
, r nat /man /unkn
Adj. Wtr. Body ,�'- ( )
❑ PWS: ❑ FC:
ORW: yes (no PNA yes (no Crit. Hab. yes no
Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length 3�a,
avg distance offshore —Q
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
SAY: not sure yes
no
Sandbags: not sure yes
no
Moratorium: n/a yes
no
Photos: yes
no
Waiver Attached: yes
no,
A building permit may be required by:
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit
Application Fee(s) Check #
(Scale: )
See note on back regarding River Basin rules.
Permit Officer's Signature
/7�'�✓a3id i l/
Issuing Date Expiration Date
Local Planning Jurisdiction
Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certifythatthis project is consistentwith the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules ❑ Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-395-3900) for more information on how to comply with thesebuffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888ARCOAST
Fax: [phone]
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-13 Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-395-3900
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01

FOLEY & FOLEY CONTRACTORS, INC.
2732
MATERIAL ACCOUNT
1810 OLD AIRPORT RD. PH. 252-636-2515
P.O. BOX 3482
NEW BERN, NC 28564 DATE 66-85/531
I � - l � LJ
PAY
TO THE
ORDER O$ 9co. 0a
-IIOLLARS LIm
RBC (�T Co
Centura 8f
RBC Cenlura Bank �f 1D0, �U
New Bern, NC 28560 QZ StC
FOR L1 PC3 7(n SG, 3(a775-3lp-f'0 3 Utz luo.ouNP
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u'0000 2 7 3 2no 1:0 5 3 L008 S1b L 6 3 6 511'

Dew O1 03 05: 23r Harry Pn� ; 52 2_49 ? 1 77
12:01:oa 19:S.1 VAN
d
AU,IA,CEN'l RIPARIAN rROPERTy OWNER STATEWNI
(131.11kheadlrip rap)
11►Frr.hy cCrtify that l own l��ol*e.rty s�djacent. t��_�
(NRme of Property t )tart('r )
pmTX-'rty.--
([.nt, Bicxk, Road, etc )
on
��� 11
(Water bDdi ,) Gown ay dloi r COUnty)
He has described to the as Shown hclO%v, the development he. is proposing a1 Tt,e
location, and, I hmve no objections to his proposal.
DESCRITTiON AND/OR DRAWING OF PROPOSED DEVEI,OPN11s N7-
(ro be filled in by indirxds4al proposing development)
d Rater
a G.
Foley & Foley Contractors, Inc
Phone## [phone]
- Fax# [phone],c
Si Lure
Print r Type Namc
Telephone ]cumber
Fe 2r� %
Date
Fe�o,
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RCi= PEDIATRIC Fa.x_919-966-7490
Dec 1 2003 17:12 P.01
1�%a2!09 16; 06 F.0
1-)��
+ADJACENT S'ARIAN PROPERTY OWNIER S-rATEAiEN l
(-BMft"P rap)
I hrnby certify that I awn Prcgxr'ty adjacent to ;(�,t �. f ,�..
s
(Nttmc of Property Qvrrscr)
Pf"ftY located -at
(Lod Block MOO etc.)
in
(Town or County) , N,C.
HO has described to me" shown below, the dMloptant he is pcWft JLt the
'gym aid, I hue no objectiom to ltia proposal_
DESCRIPTION AND/OR DRAWING Op PROPOSED DEVELOPMEIi`
(to be filled in by indiv+bf *1prvp0Wmg dst�lo pdt AI)
A&0j R A',*- Clams
4 'a:':� L
Foley dt Fotvy CgrMuctoM inc,
FhOW:(2,52)636-2515
FW [phone]Vk
Wd� .
p 6 Q a d 1)
5i gr►sttiue
Print or Type Name
'P/f -93 2
"Teiephane Number
Date —_�
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